Thursday, July 28, 2011

Shift system for future docs

THE talk lately has been on the surplus of junior doctors. As a houseman in the biggest hospital in the country, I’ve seen what the numbers have done to us.

However, what I am yet to see any good measure taken to resolve the problem.

It is understandable why we are not getting the necessary experience, due to the sheer number of housemen in the wards.

Often, we have to compete to perform a clinical procedure and even have to tiptoe on our ward rounds and stretch our necks to actually see what is happening. At times, it feels like medical school again.

Imagine a crowd of 20 housemen following about seven senior doctors during their rounds.

Due to the large number of junior doctors, many of us only take care of a minimal number of patients each which is not an optimum ratio needed to learn.

We have a good number of housemen who use this opportunity to skive off during office hours.

However, to blame it all on this number is short-sightedness since this has been happening long before the current problem of excess doctors arose.

Malaysia’s working system has long followed the British tradition of doctors working long hours.

Understandably, being a former colony, we are trying our best to emulate our former master.

It was also understandable why such dreadful working hours exist.

Back then there were not enough doctors, so someone had to stay on-call to cover the wards at night.

However, no one can deny that working long hours (normally around 36 hours non-stop), is not doing any good.

There is much hypocrisy in the medical fraternity in advising patients to get a good sleep, when most doctors are up at night, working and running around the wards.

We have had many cases, some of it fatal, as a consequence of inadequate rest.

Nowadays, with the European Working Directives, Britain has adopted the shift system, so doctors work 48 hours a week.

Being a graduate from Britain, I’ve seen the reluctance of the “old-school” doctors to change, but eventually they believe it is necessary.

So, why can’t a similar practice be implemented in Malaysia.

With shift work hours, we can effectively reduce the length of working hours for junior doctors, so that they will come to work fresh.

Furthermore, it will reduce the number of housemen in the ward at a particular time, giving a more reasonable doctor to patient ratio and better clinical experience.

I look forward to the day when the shift system is implemented so that senior doctors will stop moaning about the number of junior doctors and focus on teaching them.